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Soluble intercellular adhesion molecule-1 in cerebrospinal fluid: An indicator for the inflammatory impairment of the blood-cerebrospinal fluid barrier

1993; Elsevier BV; Volume: 47; Issue: 2 Linguagem: Inglês

10.1016/0165-5728(93)90023-r

1872-8421

Peter Rieckmann, K. Nünke, M. Burchhardt, M. Albrecht, Jens Wiltfang, Michael Ulrich, K. Felgenhauer,

Immune Response and Inflammation

A soluble form of the intercellular adhesion molecule- (sICAM-1) was measured in paired cerebrospinal fluid (CSF)/blood samples from 123 patients with differenr neurological diseases. Mean levels of circulating ICAM-1 in the blod were mean ±SD = 423 ± 184.6 ng ml−1 (range 44–1115 ng ml−1). Considerable differences of sICAM-1 in the CSF of patients wre observed between disease groups. In accute bacterial maningitis, sICAM-1 levels as high as of the serum concentration were detected in the CSF (n = 24; mean ± SD = 33.0 ± 23.7 ng ml−1; range: 4.8–93.9 ng ml−1). These changes coincided with a sever blood-CSF barrier dysfunction as indicated by a high CSF/blood ration for albumin (mean ± SD = 46.7 ± 52.2; range: 16.8–249.3). In patients with polyradiculitits (n = 9; mean ± SD = 14.5 ± 11.9 ng ml−1; range: 2.6–43.7 ng ml−1) a similar convariation between the albumin and sICAM CSF/blood ratios was detected. In patients with multiple sclerosis (n = 9; mean ± SD = 5 ± 4.3; arange: 0–12.7 ng ml−1 or HIV infection with neurological symptoms (n = 18; mean ± SD = 4.9 ± 3.2; range; 1–11.9 ng ml−1) low levels of sICAM-1 were detected in the CSG associated with intact blood-CSF barrier function in most patients. Among 13 patients with viral meningitis, only four had detectable levels of sICAM-1 in their CSF (mean ± SD = 1.0 ± 1.5 ng ml−1; range: 0–3.7). Interestingly, in a groupof patients with non-inflammatory disorders of the CNS soluble ICAM-1 was present only in three out of 50 CSF samples despite indication for blood-CSF barrier dysfunction in most cases. Repeated lumbar punctures revealed that persistent high CSF/serum ratios for sICAM-1 were associated with poor outcome. In patients with inflammatory diseases of the CNS, a signoficant correlation was observed between CSF/serumratios for albumin and sICAM-1 ([ifn = 169; r = 0.67; P < 0.001), whereas no relation between these parameters was detected in patients with non-inflammatory diseases These results indicate that sICAM-1 is a reliable marker for an inflammatory process within non-inflammatory process within the CNS which is associated with blood-CSF barrier distrubance.